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Development of New Circulatory Assist Device-Split-Circulation Assits Device

新型循环辅助装置-分流循环辅助装置的研制

基本信息

批准号：
08558104
负责人：
MIYAWAKI Fujio
金额：
$ 12.99万
依托单位：
National Cardiovascular Center Research Institute
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (A)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1998
项目状态：
已结题

项目摘要

The split-circulation assist device (SCAD) divides the systemic circulation in two by descending aortic occlusion ; the upper part is maintained by the heart assisted by intraaortic balloon pumping (IABP), and the lower is by percutaneous cardiopulmonary support (PCPS). 1) SCAD made easier the assessment of cardiac performance by excluding the variable 'bypass flow rate' of PCPS from the upper circulation. 2) SCAD increased the IABP effects. 3) SCAD set different arterial pressure in the upper circulation from that in the lower one, for example, by maintaining a minimum possible aortic pressure while keeping the maximum possible renal artery pressure in patients with renal dysfunction. A SCAD catheter made for animal experiment had a 12-cc pumping balloon and two 4-cc occlusion balloons, which were inflated alternately, thereby preventing the continuous ischemia to Adamkiewicz arteries. The catheter shaft was mad smaller at the balloon segment (7 Fr) whereas the other segment was 1arger (8 Fr) in order to prevent the balloon segment from being bulky when the balloons were wrapped. This structure also maintained high performance of IABP.A con troller for the two balloons was developed and programmed to split the circulation continuously by setting an overlap period (OP) when the inflation of both balloons were overlapped. The OP and the phase from one inflation to the next were set at ranges of 1.5 to 7.5 and 20 to 60 sec, respectively. An inflation pressure of 200 mmHg ensured the continuous split-circulation against mean blood pressure of 100 mmHg even when the OP was set at 1.5 sec. The SCAD catheter and the controller were tested in five dogs. The balloon pumping and the continuous split-circulation were successful in all the cases. After 2 to 3 hr pumping, no obvious injury was observed at the sites of balloon pumping an occlusion.

分离循环辅助装置(SCAD)通过降主动脉阻断将体循环分为两部分，上部通过主动脉内球囊反搏(IABP)辅助心脏维持，下部通过经皮心肺支持(PCPS)维持。1)SCAD通过从上循环中排除可变的PCP的“旁路流量”，使心功能的评估更容易。(2)SCAD增强IABP效应。3)SCAD在上循环和下循环中设置不同的动脉压，例如，在肾功能不全的患者中，通过维持最小可能的主动脉压，同时保持最大可能的肾动脉压。动物实验用的SCAD导管有一个12cc的泵送气囊和两个4cc的闭塞气囊，它们交替充气，从而防止Adamkiewicz动脉的持续缺血。为防止球囊包裹时球囊段体积较大，球囊段(7Fr)的导管柄较小，另一段较长(8Fr)。这种结构还保持了IABP的高性能。开发并编程了两个气球的控制器，当两个气球的充气重叠时，通过设置重叠周期(OP)来连续分离循环。OP和从一次充气到下一次充气的阶段分别被设置在1.5到7.5秒和20到60秒的范围内。即使在OP设置为1.5秒的情况下，200 mm Hg的充气压力也能确保在平均血压为100 mm Hg的情况下持续分离循环。在5只狗身上对SCAD导管和控制器进行了测试。气囊反搏和持续分流均获成功。抽吸2~3h后，球囊抽吸咬合部位未见明显损伤。